Weightlifting and sprinting for an asymptomatic individual w/ moderate aortic regurgitation

Hi All,

This is my first question and quite honestly I'm pretty new (and overwhelmed) about learning of my heart disease.  I'm hoping that somebody can offer advice about weightlifting and sprinting for a person with moderate aortic valve leakage.  I am 29 years old and for the past 8 years I have lifted very much like an athlete focusing on max strength exercises.  I also enjoy sprinting 2-3 times a week, usually for short distance events such as 100m or 200m.

I first discovered about my condition after a routine physical, which I haven't had in ages.  I was immediately referred to see a cardiologist and Cardiologist1 diagnosed me with 'severe aortic regurgitation' but said it was ok to continue my strenuous lifting regimen.  I sought a second opinion and Cardiologist2 diagnosed me with 'moderate aortic regurgitation'.  However, he wants me to exclude heavy lifting and sprinting from my workouts completely.  Both cardiologists have an athletic mind set (the first guy played b-ball at Northwestern and the second played b-ball at Duke), so they understand the mind of an athlete.

I'm really confused because isn't weight training supposed to be good for the heart?  If I can't lift heavy, how am I supposed to get stronger (or faster)?  Part of me believes this advice is precautionary in nature and meant to let me know that a risk is involved.  Yet, another part fears that my heavy lifting may be digging my grave with each heavy rep.

I'm clueless to what I should do.  I love lifting and it has been a major part of my life.  I was curious if anybody could shed some light on athletic training for an individual with heart valve disease?  

- Grade 3 diastolic blowing murmur
- Grade 1 short systolic ejection murmur
- No enlargement of thyroid gland or liver; chest and adbomen both cleared
- Blood tests indicate nothing out of range except slightly high LDL at 103
- 45% ejection fraction; aortic root 3.7cm
- no symptoms of pain

Thanks,

Matt

[Cleveland Clinic]

It depends on who is exactly correct. It sounds that with a decrease EF, if this is related to the aortic disease ( as evidenced by a dilated left ventricle) means the aortic regurgitation is severe and not moderate. You may need a TEE to see what the actual amount of AR is and the mechanism for this leakage. A cardiac MRI can be very useful if the grade is not clear after TEE as this modality is very good at actual volumetric measurements.  
If you have severe AR and a decrease EF, then you may benefit from open heart surgery. IF not then the progression of this disease has been shown to be decreased by the use of calcium channel blockers and statins to a lesser extenct. The first one f these decreases blood pressure and that is what you are trying to avoid by telling you to stop weight lifting or sprinting. This sort of exercise has never been shown to be beneficial to the heart, as they tend to cause high blood pressure and large variations in intrathoraccic pressures and pulse fluctuations.

[Fionajnz]

Your Ejection fraction is a bit below normal, which often means that your heart is not pumping efficiently and may be enlarged a bit.  I am not an athlete, but I have had an EF of the same number and a bit lower and I felt pretty cr@ppy but I had a PE too.

I am not sure whether the fact that you have such an athletic background may mean that you remain asymptomatic.  In your shoes I would probably seek a third opinion at a teaching or center of excellence for cardiology.  Meantime probably play it safe and do what feels comfortable.  It seems like keeping some routine is fine, maybe just fine tuning it a tad until you know and understand more info on your situation.

Fiona  

[arokisbobcat]

Thanks Fionajnz for making a comment.  When I learned about my EF and how low it is relative to what is normal, I was quite shocked too.  One of the cardiologists even mentioned how my great conditioning is probably preventing syptoms (symptoms) from rearing their head.

I've been searching on the web and have been looking for information (actual data; numbers!) regarding introthoracic pressure placed on the heart from a valsalva and how certain activities/sports stack up in regards to this.

Unfortunately, I haven't been able to find such a study with actual numbers and such.  Perhaps if anyone knows of one please pass along.

Thanks!

[davidgs]

A related discussion, Can mild aortic insufficiency be exacerbated by weight lifting?   was started.